Alcohol and Cannabis Co-Use Among Young Adults

The simultaneous use of alcohol and cannabis has become a concerning trend, particularly among young adults aged 18–25, who are often navigating newfound independence in university or college environments. This behaviour, referred to as alcohol and cannabis co-use, involves the consumption of both substances on the same day, whether simultaneously (overlapping effects) or concurrently (separated by time but within the same 24-hour period). Some may perceive co-use as a way to enhance pleasurable experiences, but it significantly risks health, safety, and long-term well-being.

Prevalence and Patterns of Use

Research indicates that alcohol and cannabis consumption peak during early adulthood. Approximately 31% of young adults report engaging in binge drinking, while 11% use cannabis on a daily or near-daily basis. Alarmingly, 25% of those who consume alcohol also report cannabis use, reflecting a rising trend in alcohol and cannabis co-use, particularly among college students who live away from home.

This demographic, often not under direct parental supervision, is more likely to experiment with risky behaviours. Co-use of these substances is especially common in social contexts that promote relaxation, fun, and connection, yet come with dangerous consequences.

Why Do Young Adults Engage in Co-Use?

One key factor driving alcohol and cannabis co-use is the pursuit of pleasure. Numerous studies have documented that young adults perceive co-use as more enjoyable compared to consuming either substance on its own. Individuals report experiences such as enhanced euphoria, reduced stress, and feelings of social bonding when alcohol and cannabis are used together.

Laboratory studies suggest that when alcohol is consumed, it heightens the absorption of THC, the active ingredient in cannabis, intensifying sensations of euphoria. This additive or synergistic effect can reinforce the desire to co-use, even for those who may feel ambivalent about either substance independently.

Motivations for this behaviour also extend to enhancement motives, suggesting that young adults co-use in pursuit of an elevated mood or heightened pleasure. However, while they report enhanced enjoyment, research has found that this perception of increased pleasure may not always correlate with their actual experience.

Acute and Long-Term Risks of Co-Use

While the simultaneous use of alcohol and cannabis may appear pleasurable in the moment, it is critical to underscore the severe risks associated with this behaviour. Co-use heightens the likelihood of experiencing acute negative outcomes, including:

Hangovers and blackouts from excessive alcohol consumption.
Cognitive impairment and memory issues exacerbated by combining substances.
Respiratory and cardiovascular problems, particularly for individuals prone to health complications.
Substance use disorders, with increased potential for dependency when mixing substances regularly.

Alcohol and cannabis co-use poses dangers that extend beyond the short term. Prolonged or frequent use can impair decision-making abilities, erode mental health, and contribute to academic decline. Furthermore, the presence of synthetic substances such as fentanyl in counterfeit cannabis products has amplified the risk of overdose.

Young adults who engage in this behaviour often dismiss these risks, falsely believing that the temporary pleasures outweigh the likelihood of harm they may face later in life.

The Complex Dynamics of Pleasure

While co-use is associated with an increased probability of experiencing substance-related pleasure, this pleasure often masks the immediate and long-term dangers attached to the behaviour. Studies using diary-based methods have revealed that young adults self-report more moments of enjoyment on days when they engage in alcohol and cannabis co-use. However, closer analysis has shown that most of this heightened pleasure stems from the effects of alcohol rather than cannabis or the combination.

Interestingly, while individuals may claim they feel “better” when combining substances, their actual level of pleasure is not substantially greater than when consuming alcohol alone. This discrepancy suggests that co-use occurs not only due to the perceived enhancement of pleasure but because of social and environmental pressures that normalise and encourage risky behaviours.

The societal cost of alcohol and cannabis co-use is significant. Beyond immediate health consequences, engaging in risky behaviours serves to normalise substance dependency among peers and younger populations. For college students, the practice of regular co-use diminishes their ability to fully engage in educational opportunities, raising the likelihood of academic failure and decreased life prospects over time.

Additionally, individuals who combine alcohol and cannabis are more likely to engage in unsafe behaviours such as impaired driving, violence, or unprotected sex, broadening the scope of harm to themselves and society. Family and friends often feel the ripple effects, including emotional distress and strained relationships.

Moving Towards Prevention

With increased reports of alcohol and cannabis co-use in young adults, educational institutions, healthcare providers, and families must take collective action to minimise this behaviour. The importance of raising awareness about the realities of co-use cannot be emphasised enough. Young people should be made aware of the immediate risks, such as cognitive impairment and overdose, alongside the long-term consequences that may irreparably harm their futures.

Efforts must focus on prevention strategies that guide young adults towards making healthier choices. Schools and universities must establish support systems that dissuade substance use while encouraging meaningful engagement in alternative activities. Rather than normalising the pursuit of pleasure through substances, fostering opportunities for natural social bonding, exercise, and creativity offers lasting rewards without compromising well-being.

Furthermore, clear communication from families and strict regulations surrounding substance accessibility help reduce instances of co-use. Educators, community leaders, and healthcare professionals can also work together to develop robust intervention programmes that address peer pressures and social misconceptions early on.